This Is Going to Hurt ending explained: Adam reveals the truth behind Shruti's death to the tribunal

This is Going to Hurt debuted in 2022, and the ending showcased Shruti dying by suicide after struggling under the relentless pressure of her job, isolation, and fear of failing her exams. Her death highlights the emotional toll of the medical profession on young doctors.

The finale episode opens after two months of this incident, and Adam returns to the hospital routine. He delivers babies and, meanwhile, also waits for his hearing, stating his fitness to continue medical practice after the fallout with Erika.

Adam is hurt and is under guilt after Shruti's death, and is seen to go to the tribunal for discussion. One of his colleagues suggests that he blame Shruti for Erika's case so that it becomes nobody's fault, highlighting the crude environment they are in. By the end of the episode, we learn what Adam reveals to the tribunal. Adam highlighted how broken the medical system is and how it grinds its brightest doctors, while Shruti chose to die as she couldn't see her future in this.

This is what happened in the finale episode of This is Going to Hurt

The hospital is holding a memorial for Shruti in the car park, and Adam leaves to attend it in episode 7 of This Is Going to Hurt. When Adam heads out for the memorial, his beeper beeps, and he is called to another emergency. But this time, Julian steps in so that he can go.

Ms Houghton unveils a tree planted in Shruti's honour, who had passed her Part One exams on her first attempt. Adam confronts her after the ceremony about stating that Shruti was "happy" at work. Adam insists on the internal investigation, but Houghton shuts him down. On the other hand, Lockhart suggests that Adam should blame Shruti for Erika's early discharge so that nobody loses.

When Adam heads to the tribunal, he is haunted by Shruti's visions, and whether he blames her is left ambiguous. Later, when he meets Greg, Adam asks him if his recruiter friend knows of any job outside medicine.

Back at the hospital, Adam then runs into Erika, who is taking her baby home. Erika thanks Adams for everything and hands him a small gift, a best doctor mug. There were two, one for him and another for Shruti. This moment makes Adam smile amidst the most difficult situation he has been in. Adam is then called to deliver a baby in a special case. With the mother's consent, he decides to break the mother's pelvic floor and free the baby. He was able to save him and earn appreciation from Tracy while the tension between them finally broke.

Here is how the finale episode of This is Going to Hurt ended

At Greg's wedding, Adam bonds with Greg's pregnant wife and gifts her a baby monitoring device. Harry also joins the reception. However, soon Harry and Adam slip out of the wedding, racing down to the river with a bottle of wine. Eventually, he tells Harry that he is considering quitting medicine to give their relationship a chance. But Harry tells him that maybe he can never live without medicine.

By the end, we learn what Adam said at the tribunal. He told the panel how Shruti decided to take her life even after passing her exams because she was unable to imagine her future in a broken healthcare system. A system that tends to grind the brightest of doctors.

In the last scene of This is Going to Hurt, Adam is seen delivering a baby in the car park, again under emergency conditions. His shirt is still damp from last night's river escape, and when the mother asks him what could be the best name for the newborn. He replies,

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“Adam is a nice name.”

This way, This is Going to Hurt ends on a hopeful and warm note. No matter what, Adam can never leave, bringing new life.

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